Nov 14, 2017 - life-saving air medical care with bipartisan legislation S. 2121, the ... service, a critical element of
November 14, 2017 The Honorable Michael Bennet 261 Russell Senate Office Building Washington, DC, 20510
The Honorable Cory Gardner 354 Russell Senate Office Building Washington, DC 20510
The Honorable Dean Heller 324 Hart Senate Office Building Washington, DC 20510 CC: The Honorable Jackie Walorski 419 Cannon House Office Building Washington, DC 20515 Dear Senators: We are writing to express our support for your efforts to preserve and protect access to high-quality and life-saving air medical care with bipartisan legislation S. 2121, the Ensuring Access to Air Ambulance Services Act. This legislation will help ensure that communities across the country can maintain access to air medical service, a critical element of healthcare delivery in the United States – particularly in rural communities. Since 1990, more than 22% of American hospitals have closed, and today, there are hundreds of additional hospitals that are on the brink of closure in rural America. The result is that patients must travel farther to get emergency care, when time is essential to their health and wellbeing. 90% of air medical patients are being transported because they have suffered serious cardiac, stroke or other traumatic events. Trauma doctors know that time is critical for these types of patients, and that the right kind of immediate medical care can lead to vastly better outcomes with regard to saving lives and preserving quality of life. However, about 115 million Americans live more than an hour from a Level 1 or Level 2 trauma center if driven by ground ambulance. Air medical transport providers are an essential component of the health care delivery system because they ensure that all Americans can get the definitive care they need in the timeliest manner possible. Like a fire station, air medical crews deploy 24 hours a day, seven days a week, 365 days of the year. They deploy only when they are called in by a first responder or attending physician, and regardless of what type of insurance coverage a patient has, if any. Operating an air medical base costs an average of $3 million dollars annually. Unfortunately, communities that rely on air medial transports for timely access to emergency medical care are at risk because Medicare vastly under-reimburses providers for this service. In fact, the average Medicare reimbursement is about 30-50% of actual transport costs. Medicare reimbursement for air medical services has not been updated in almost 20 years. Moreover, when the fee schedule was first developed in 1998, it was not based on actual provider costs. Meanwhile, in the last 10 years, costs for providing air medical services have more than doubled, and the percentage of patients transported by air medical who are Medicare patients has grown to over 35%, and continues to increase.
The result is a major reimbursement shortfall that is threatening access to all emergency air medical services. Medicare’s extreme under-reimbursement makes it hard for bases to remain open, and where they remain, costs are unduly shifted to the 30% of patients who have private insurance. This is not sustainable. We are grateful that you are taking steps to address this reimbursement shortfall, preserve access to air medical services, and bring more rationality to the payment system through your legislation that would: • • • • •
Require air medical operators to collect and submit cost data to Health and Human Services so that it can develop an accurate payment system based on actual costs of providing care; Establish a mandatory air medical quality reporting program; Implement a value-based purchasing program to promote high-quality air medical services; Provide reasonable immediate, but temporary, relief to providers while the data collection and analysis is occurring; and Remain budget neutral by penalizing providers who fail to report on cost and/or quality, using the value-based purchasing program to collect savings in a trust fund, and utilizing general HHS funds to offset any spending increases.
Because of your leadership on protecting access to emergency air medical services, we now have strong legislation in the Senate and House of Representatives, S. 2121 and H.R. 3378, the Ensuring Access to Air Ambulance Services Act, that would preserve a critical element of our nation’s health care system and emergency response infrastructure. Thank you for your dedication and attention to this important issue that affects millions of Americans who rely on these life-saving services. Sincerely, Save Our Air-Medical Resources (S.O.A.R. Campaign) American Medical Women’s Association (AMWA)
Helicopter Association International International Association of Flight and Critical Care Paramedics (IAFCCP) Mothers Against Drunk Driving (MADD)
American Nurses Association (ANA) National Air Transportation Association Association of Air Medical Services (AAMS) Consumer Action
National Association of State EMS Officials (NASEMSO)
Consumer Health Coalition
National Stroke Association
Epilepsy Foundation
